[Reprinted  from  The  Modern  Hospital,  September,  1914,  Vol.  Ill,  No.  3.] 


CULTURE  COURSES”  IN  TRAINING  SCHOOLS 
FOR  NURSES. 

BY  EDITH  KATHLEEN  JONES, 

Librarian  at  McLean  Hospital,  Waverley,  Mass. 

Ever  “the  old  order  changeth,  giving  place  to  new.”  If 
Sairey  Gamp  has  disappeared  completely  below  the  nurs- 
ing horizon,  no  less  certainly  is  there  rising  a new  ideal 
for  the  profession,  a nurse  who  shall  be  not  only  the  right 
hand  of  the  physician  and  the  surgeon  and  the  mainstay 
of  the  disordered  household,  but  also  a congenial  com- 
panion for  the  patient.  In  convalescent  and  mental  cases, 
especially,  the  successful  nurse  is  one  who  can  arouse  in- 
terest and  attention  and  induce  the  patient  to  enter  again 
into  normal  relations  with  the  world. 

That  convalescent  and  mental  nursing  require  more 
tact  and  sympathy  and  patience  than  any  other  sort,  no 
one  knows  better  than  the  nurse;  but  of  the  fact  that 
often  the  whole  long  medical  battle  is  finally  won  or  lost 
through  the  personality  of  the  nurse  during  this  trying 
time  the  physician  is  desparingly  aware.  While  the  doc- 
tors can  get  plenty  of  nurses  efficient  in  an  emergency, 
capable  and  deft  in  the  more  mechanical  aspects  of  their 
profession,  they  complain  that  it  is  very  difficult  to  secure 
attendants  with  the  education  and  resources  which  would 
render  them  companionable  and  congenial  to  their  more 
highly  educated  and  cultivated  patients.  Tact,  sympathy, 
skill,  and  patience — these  qualities  are  indispensable;  but 
if  to  them  a nurse  can  add  a knowledge  of  books,  an  ap- 
preciation of  pictures,  an  interest  in  current  events,  she 
will  have  at  her  command  resources  which  will  give  her 
tremendous  advantages  in  the  way  of  entertainment  and 
companionship;  and,  incidentally,  she  will  come  pretty 
near  to  being  the  perfect  woman,  whose  price,  according 
to  Solomon,  is  above  rubies. 

Since  the  demand  is  for  this  ideal,  what  are  the  train- 
ing schools  to  do  toward  supplying  such  nurses?  In  the 
general  hospitals  there  has  been  much  serious  discussion 
of  the  subject,  and  two  plans  have  been  proposed:  one, 
that  a higher  grade  of  education  be  required  for  entrance 
into  the  training  schools;  the  other,  that  these  schools  add 
to  their  curriculum  lectures  in  current  events,  literature, 
and  general  culture.  The  first  plan  would  shut  out,  from 


both  general  and  mental  hospitals,  many  of  our  best  nurses 
— girls  who  are  intelligent  and  ambitious  and  eager  to 
learn,  but  who  have  had  few  advantages — and  it  is  impracs 
ticable,  for  the  present  at  least,  because  the  supply  would 
not  equal  the  demand.  As  a rule,  college  educated  men  and 
women  do  not  take  up  nursing  as  a profession.  There  re- 
mains, then,  the  second  scheme,  that  of  introducing  so- 
called  “culture  courses”  into  the  training  schools. 

In  a way,  this  is  not  a new  idea.  For  years  past  more 
or  less  tentative  efforts  have  been  made  in  many  hospi- 
tals to  give  their  pupil  nurses  lectures  on  current  events 
and  topics  of  the  day,  but  in  few,  if  any,  cases  have  these 
lectures  been  such  an  unqualified  success  that  they  have 
been  included  permanently  in  their  curriculum.  Perhaps 
one  reason  for  their  failure  is  the  fact  that  they  were 
usually  merely  desultory  lectures,  and  not  a part  of  the 
required  course,  for  unless  one  has  an  inborn  love  of 
study,  or  his  interest  is  very  thoroughly  aroused,  he  is 
not  apt  to  do  any  more  studying  than  is  obligatory. 
Another  cause  for  the  nonsuccess  of  these  lectures  may  be 
the  lack  of  teachers  within  the  hospital  to  keep  the  stu- 
dents interested,  and  the  absence  of  an  adequate  library. 
Teachers  may  be  imported — at  a cost;  books  may  be  bor- 
rowed from  the  nearest  public  library,  but  at  a certain 
inconvenience  and  much  responsibility  for  someone,  and 
few  hospitals  care  to  surmount  these  obstacles. 

Taking  into  consideration  these  attempts  by  other  train- 
ing schools,  when  McLean  Hospital  contemplated  giving 
some  such  courses  to  its  pupil  nurses,  it  counted  as  its 
greatest  asset  a well-selected  library  of  more  than  seven 
thousand  volumes.  It  had  always  been  a matter  of  re- 
gret that  the  nurses  did  not  make  better  use  of  the  ma- 
terial at  hand,  and  for  ten  years  it  had  been  the  dream  of 
the  librarian  that  “somewhere,  somehow,  somewhen,”  time 
should  be  found  to  give  instruction  to  the  nurses  in  books 
and  reading,  with  the  view  of  securing  to  a greater  ex- 
tent their  cooperation  in  the  efforts  of  the  library  to  get 
books  to  the  patients.  In  the  fall  of  1913  it  was  decided 
to  try  something  of  the  sort  as  an  experiment,  and,  if  it 
seemed  successful  and  was  appreciated  by  the  nurses,  to 
add  it  permanently  to  the  curriculum. 

As  a beginning,  six  lectures  on  the  development  of  the 
English  novel  were  given  in  October  to  the  women  of  the 
senior  class.  They  were  made  compulsory  to  the  women, 
but,  because  it  was  not  thought  the  men  would  care  for 
them  and  it  was  difficult  to  spare  them  from  the  wards, 


2 


iWt 


v Ip 

sT^  b c 


v\j 


DEMOTE Si 


OH/\GE 


k 

the  men  were  not  at  first  included.  Although  an  experi- 
ment, and  given  by  one  who  had  had  no  previous  experi- 
ence in  teaching,  yet,  if  success  is  measured  by  awakened 
▼ enthusiasm  for  books  worth  while,  eagerness  to  do  the  re- 

quired work,  and,  upon  the  whole,  fairly  satisfactory  re- 
sults in  the  examinations,  this  course  was  a success,  and 
certainly  it  was  appreciated.  So  many  graduate  nurses 
still  in  the  hospital  service  and  men  of  the  senior  class 
expressed  their  regret  that  they  were  unable  to  attend 
the  afternoon  lectures,  that  at  their  request  the  course 
was  repeated  in  evening  classes,  at  which  attendance  was 
entirely  voluntary.  It  means  an  eagerness  to  seize  op- 
portunity when  men  and  women  who  have  been  hard  at 
work  all  day  on  the  wards  are  not  only  willing,  but  de- 
sirous, to  give  up  an  hour  of  freedom  after  8 o’clock  at 
night  to  attend  lectures  which  are  not  compulsory. 

At  the  end  of  the  course  the  nurses,  like  Oliver,  de- 
manded more.  As  the  library  was  particularly  rich  in  its 
fine  arts  department,  this  subject  was  chosen  for  a second 
course,  given  in  the  spring  term  to  the  entire  senior  class. 
This,  too,  was  fully  appreciated  by  most  of  the  members, 
and  with  few  exceptions  they  did  remarkably  good  work; 
in  fact,  the  hospital  felt  that  both  courses  were  enough  of 
a success  to  warrant  giving  them  another  year. 

It  is  no  part  of  the  plan  of  this  paper  to  give  a synopsis 
of  these  two  subjects  as  taught  at  McLean  Hospital,  or 
to  go  into  details,  except  as  they  may  serve  as  suggestions 
to  other  hospitals  planning  something  of  the  sort.  The 
courses  were  made  compulsory  because  it  was  felt  it  might 
not  be  possible  to  hold  the  attention  and  interest  of  the 
students  in  any  other  way,  once  the  novelty  had  worn  off, 
and  examinations  were  given  because  they  tend  to  fix  a 
subject  in  the  mind.  There  was  no  attempt  at  a complete 
course  in  English  literature  because  of  the  shortness  of 
the  time  at  the  disposal  of  the  class,  but,  as  fiction  repre- 
sents by  far  the  greatest  amount  of  reading  matter  of 
the  present  day,  a very  brief  summary  of  the  English 
novel  was  given,  from  the  old  ballads  and  romances  to 
the  very  latest  “best  seller.”  The  required  reading  con- 
sisted of  a few  of  the  great  books — at  least  one  of  Jane 
Austen,  Scott,  Dickens,  George  Eliot;  either  “Vanity  Fair” 
or  “Henry  Esmond;”  “Westward  Ho!;”  “Huckleberry 
Finn”  or  “Tom  Sawyer;”  “The  Scarlet  Letter”  or  “The 
Marble  Faun;”  “Treasure  Island”  or  “Kidnapped;”  several 
of  Kipling’s  short  stories;  a choice  of  several  other  nov- 
els. The  idea  was  not  only  to  show  how  the  novel  grew 


and  changed  from  century  to  century,  but  also  to  intro- 
duce the  class  to  the  very  best  writers,  so  that  they  might 
have  an  ideal  by  which  to  measure  the  stories  of  the 
present  day.  They  were  asked  to  write  a short  paper  on 
their  favorite  author  or  book,  and  some  of  these  essays 
were  excellent  in  point  of  view  and  analysis. 

The  course  in  the  history  of  art  presented  more  diffi- 
culties and  took  much  more  time.  Roughly  speaking,  it 
was  based  on  Reinach’s  ‘‘Apollo,”  which  many  of  the  class 
purchased;  but,  realizing  that  most  of  the  ground  cov- 
ered would  be  entirely  new  to  many  of  the  students,  and 
that  they  would  have  little  time  for  outside  reading,  the 
lectures  were  very  carefully  prepared  to  give  all  the  infor- 
mation possible  in  the  class;  the  outline  of  each  lecture,  as 
well  as  new  names  and  terms,  were  written  on  the  black- 
board, and  rough  sketches  were  drawn  to  illustrate  some 
points.  But,  most  important  of  all,  large  photographs 
and  (when  it  was  possible  to  get  good  ones)  colored  pic- 
tures were  displayed  on  the  platform  and  passed  among 
the  students.  Pictures  are  indispensable  in  a course  of 
this  sort,  and,  if  the  hospital  does  not  own  them,  the  pub- 
lic libraries  and  art  museums  will  be  found  willing  to  lend 
their  collections,  or,  indeed,  to  help  in  any  way  possible. 
While  on  the  subject  of  pictures,  it  may  be  said  in  passing 
that  the  very  best  colored  reproductions  known  to  the 
writer  are  published  in  “Die  Galerien  Europas,”1  and  sep- 
arate pictures  may  be  purchased  at  25  cents  each.  To 
those  who  have  never  seen  any  paintings  by  the  great  mas- 
ters, a photograph  conveys  a very  inadequate  idea,  and 
cheap  colored  prints  are  worse  than  nothing;  but  in  these 
pictures  the  individual  tones  and  colors  are  wonderfully 
well  reproduced,  and  a good  idea  of  the  peculiar  style  of 
each  artist  can  be  obtained. 

Speaking  from  one  year’s  experience,  it  would  seem 
worth  while  to  devote  one  lecture  to  Greek  and  Roman 
mythology,  and  it  certainly  adds  greatly  to  the  intelligence 
of  the  students  if  a brief  outline  is  given  of  the  physical 
geography,  history,  and  characteristics  of  each  nation  and 
their  effect  on  their  art.  Since  this  course  is  meant  for 
“general  culture”  rather  than  an  exhaustive  study  of  art, 
the  broader  and  more  fundamental  one  can  make  it  the 
more  the  nurses  will  get  out  of  it. 

In  a pioneer  work  like  this,  with  an  inexperienced 
teacher,  it  was  inevitable  that  there  should  be  mistakes. 

tDie  Galerien  Europas  ; Leipzig,  Seemann.  The  volumes  are  pub- 
lished by  subscription,  but  they,  or  separate  pictures,  may  be  secured 
through  any  foreign  bookseller. 


4 


Perhaps  the  greatest  of  these  lay  in  trying  to  give  too 
many  names  and  facts,  too  much  detail,  and  in  taking  for 
granted  more  previous  knowledge  than  many  of  the  stu- 
? dents  had.  Another  year  only  the  most  important  items 

will  be  given,  but  these  will  be  hammered  home.  More 
frequent  reviews  and  examinations  will  be  given.  The  art 
course  will  immediately  follow  the  literature  and  be  ex- 
tended throughout  the  school  year,  making  it  much  less 
hurried. 

The  greatest  difficulty  encountered  was  in  finding  a 
point  of  contact  from  which  to  start,  for,  while  some  mem- 
bers of  the  class  were  well  educated  and  had  read  widely 
and  intelligently,  many  of  them  had  had  few  opportunities. 
When  Dickens  is  only  a name  and  Jane  Austen  not  even 
that;  when  Florence  is  merely  a dot  on  the  map  and  Rome 
a city  in  Italy  where  vague  things  once  happened;  when 
Homer  is  thought  to  have  written  the  Arthurian  romances, 
and  Mars  and  Eros,  Zeus,  Venus  and  Hermes,  whether 
under  Greek  or  Roman  names,  mean  absolutely  nothing; 
when  Raphael  and  Rembrandt  are  known  simply  as  “ar- 
tists” and  convey  no  distinctive  impression — where  is  one 
to  begin  ? Yet,  if  the  outlook  is  at  first  a little  appalling, 
so  much  the  greater  is  the  need  for  a start.  With  a good 
library  at  hand,  a judicious  selection  of  books  can  be  made 
and  put  for  two  or  three  months  in  the  nurses’  sitting 
rooms,  where  they  may  be  taken  up  at  odd  moments,  read 
aloud  and  talked  over.  In  this  way  something  of  history 
and  mythology  may  be  imbibed  almost  without  knowing  it, 
and  one  may  become  acquainted  with  the  names  at  least 
of  the  great  places  and  writers  and  artists  before  the 
courses  are  begun.  During  the  course  the  necessary 
books  might  well  be  reserved  in  some  place  accessible  to 
the  entire  class,  so  that  no  one  person  can  monopolize 
them.  It  might  again  be  emphasized  that  if  a hospital 
has  no  library  of  its  own,  the  public  libraries  will  be 
glad  to  lend  their  books. 

It  is  yet  too  early  to  speak  of  results  from  this  ex- 
periment at  McLean  Hospital,  but  it  is  true  that  the  nurses 
themselves  appreciated  what  was  being  done  for  them 
and  cooperated  heartily.  Over  and  over  again  they 
voiced  their  feeling  that  a new  world  of  books  and  pictures 
had  been  opened  to  them,  and  that,  although  they  were 
unable  to  remember  all  the  details,  they  had  acquired  a 
certain  foundation  on  which  to  build  in  the  future.  At 
least  they  became  acquainted  with  the  great  names  in 
^ literature  and  art,  and  knew  a little  of  what  they  stood 

5 


J 


for.  Moreover,  interested  themselves  in  what  was  to  many 
of  them  a new-found  world,  they  took  their  notebooks  to 
the  wards,  talked  over  the  lectures  with  the  patients,  got 
them  interested,  helped  and  were  helped  in  turn  by  them 
toward  a wider  outlook  and  a larger  range  of  interest. 
Nurses  and  patients  alike  went  over  the  lectures,  read  the 
books,  criticised,  compared  impressions,  had  more  topics 
in  common.  More  than  once  certain  patients  took  excep- 
tion to  opinions  expressed  by  the  lecturer  and  quoted  by 
a nurse,  and  called  the  former  to  account.  This  interest 
was  good  for  the  patient  and  not  at  all  bad  for  the  lec- 
turer. Although  it  was  a little  difficult  to  arrange  mat- 
ters so  that  the  whole  senior  class  could  be  spared  from 
the  wards  for  one  hour  a week  in  addition  to  the  time 
needed  for  the  other  classes,  yet,  from  this  one  year’s  ex- 
perience, it  would  appear  that  the  nurses  give  more  to  the 
patients  in  awakened  interest  and  stimulus  than  they 
take  from  the  wards  in  time.  If  such  courses  make  them 
better  companions,  and  therefore  more  efficient  nurses,  it 
would  seem  to  be  for  the  interest  of  the  hospital,  espe- 
cially for  the  hospital  for  mental  diseases,  to  give  them 
at  least  one  “culture  course”  with  their  more  technical 
studies;  while  there  is  no  doubt  that  better  education  will 
make  them  more  valuable  in  private  nursing,  whether  in 
mental  or  convalescent  cases. 


6 


» 


f 


THE  MODERN  HOSPITAL 

Published  the  First  of  Every  Month  by 

THE  MODERN  HOSPITAL  PUBLISHING  CO. 

Metropolitan  Building,  ST.  LOUIS,  MO. 

Subscription,  $3.00  per  year 


